Gurger M, Yilmaz M, Yilmaz E, Altun S
Department of Orthopaedics and Traumatology, Firat University School of Medicine, Elazig, Turkey.
Department of Plastic Reconstructive and Aesthetic Surgery, Firat University School of Medicine, Elazig, Turkey.
Niger J Clin Pract. 2018 Mar;21(3):388-391. doi: 10.4103/njcp.njcp_24_17.
Percutaneous screw fixation is widely used in acute fractures of the scaphoid. In this study, we aimed to present our results with volar percutaneous screw fixation in patients with scaphoid nonunions.
A total of 12 patients with scaphoid nonunion (≥13 weeks) that underwent volar percutaneous screw fixation were evaluated retrospectively. Two of the patients were female, and 10 were male. Mean age was 27 years (range = 19-41). The mean time that elapsed between the fracture and surgical procedure was 7.5 months (range = 4-12). According to the anatomic location, 33.3% were proximal pole, and 67.7% were waist fractures. All of the patients underwent percutaneous fixation with a headless cannulated screw from volar part under fluoroscopic guidance. Clinical evaluation was performed according to the modified mayo wrist scoring system (MMWS). The absence of a radiolucent fracture line on the radiographs was considered "union" on radiological evaluation.
The mean follow-up time was 18 weeks (range = 8-36). Union was achieved in all patients (91.6%), except one. The mean time to union was 15.5 weeks (range = 8-30). Based on MMWS system, 8 patients were interpreted as excellent, 3 patients as good.
Percutaneous fixation in appropriate patients provides satisfactory results with high union and minimal complication rates in scaphoid nonunions.
经皮螺钉固定术广泛应用于舟骨急性骨折。在本研究中,我们旨在展示掌侧经皮螺钉固定治疗舟骨不愈合患者的结果。
回顾性评估了12例接受掌侧经皮螺钉固定术的舟骨不愈合患者(病程≥13周)。其中2例为女性,10例为男性。平均年龄27岁(范围19 - 41岁)。骨折与手术之间的平均时间为7.5个月(范围4 - 12个月)。根据解剖位置,近端极骨折占33.3%,腰部骨折占67.7%。所有患者均在透视引导下从掌侧用无头空心螺钉进行经皮固定。根据改良梅奥腕关节评分系统(MMWS)进行临床评估。X线片上无透亮骨折线在影像学评估中被视为“愈合”。
平均随访时间为18周(范围8 - 36周)。除1例患者外,所有患者均实现愈合(91.6%)。平均愈合时间为15.5周(范围8 - 30周)。根据MMWS系统,8例患者评定为优,3例患者评定为良。
对合适的患者进行经皮固定可在舟骨不愈合中取得满意的结果,愈合率高且并发症发生率低。